Sacral alar and midline sacral insufficienty

@aardvark2118 Did you recently receive that diagnosis? Did you notice any symptoms?

I was diagnosed with a sacral alar and midline sacral insufficiency one year after I finished pelvic radiation for an endometrial cancer recurrence. My radiation oncologist told me prior to radiation therapy that there was a chance my bone density in the lower spine would be affected by external pelvic radiation. I had no symptoms and the fracture was found incidentally in a CT scan. Because of the sacral fracture I was referred to endocrinology and a bone density scan was ordered. Fortunately, I had a bone density scan just prior to starting the external pelvic radiation because I had just finished 4 1/2 years of alendronate medication. Prior to radiation therapy my bone density was in the osteopenia range (I'd have to look up the exact t score). After radiation therapy and with the sacral insufficiency fracture I was back in the osteoporosis range as my bone density had decreased. The endocrinologist recommended that I get Evenity injections for 12 months which I did. My bone density then increased significantly back into the osteopenia range. I had a Reclast infusion within one month of completing the Evenity to lock in the gains. I will have a follow-up exam with my endocrinologist later this year.

By the way, I have had 2 falls since completing the Evenity and Reclast infusion. Both falls happens when I was x-country skiing. I did not experience any fractures with those falls.

When did you receive your diagnosis and what is the recommendation for you?

Hello thank you for responding! I just had a PET/CT this past Wednesday and that was when the fractures were identified. I am 19 months since my last radiation (I had 25 external beam and three brachytherapy). I’ve had lower back and hip discomfort (can’t really call it pain) fir a year and it was felt to be osteopenia. I too had been warned I was at increased risk of fractures but mistakenly thought that meant if I fell. I’m wondering if o haven’t brought this on myself as due to fear of a recurrence and reading that exercise might help prevent a recurrence I have been almost obsessed with walking at least 10,000 steps a day , taking the stairs etc My rad onc has referred me back to my gyn onc to look at bone density meds and I see her April 10 . He also suggested physical therapy and I’ve already been working with them as I had a flare up of pain in my hips since last fall. Took me until late January to get an appointment and they felt the issues with my hip were related to my feet ( I have chemo induced peripheral neuropathy- jeez I sound like a wreck ) but now with this info we’ll be reviewing next week when I see them. He also suggested vitamin D so am waiting to hear from my primary doctor on dose. Sorry this is so long Have to admit cancer seems to be the gift that keeps on giving but so far I am in remission and will be two years in august. Thanks for listening (reading)

I had a pelvic insufficiency fracture 3+ months after completing pelvic ☢️ and brachytherapy. It presented to me as sciatica and I did not connect it with a fall that I had a few weeks prior. I had been diagnosed with osteoporosis years before my cancer diagnosis and was put back on a bisphosonate after the PIF was verified, along with repeated reminders of “Do Not Fall!”
I did get a PT script for balance and now meet with a trainer once a week trying to build my core (to help support my deteriorating spine) and to continue with balance exercises.
You said it so well: Cancer is the gift that keeps on giving.
(I was going to make a list of the permanent effects of treatment, but it was too depressing!)
Hang in.